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Comparison of liver stiffness measurements by a 2D-shear wave technique and transient elastography: results from a European prospective multi-centre study

  • Gastrointestinal
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Abstract

Objectives

To compare liver stiffness measurement (LSM) provided by Canon 2D-shear wave elastography (2D-SWE) and transient elastography (TE), the latter being the reference method.

Methods

Prospective study conducted in four European centres from 2015 to 2016 including patients with various chronic liver diseases who had LSMs with both 2D-SWE and TE on the same day. Median of 10 valid measurements (in kPa) was used for comparison using paired t test, Pearson correlation, intraclass correlation coefficient (ICC) and Bland-Altman plot. The ability of 2D-SWE to stratify patient according to recognised LSM-TE thresholds was assessed by ROC curve analysis.

Results

Six hundred forty patients were scanned, where 593 (92.7%), 572 (89.4%) and 537 (83.9%) had reliable LSMs by TE, 2D-SWE and both combined, respectively. In the latter (n = 537, 310 [57.7%] male, mean 55.3 ± 14.8 years), median LSM-TE and LSM-2D-SWE had a mean of 10.1 ± 9.4 kPa (range 2.4–75) and 9.1 ± 6.1 kPa (range 3.6–55.7) (paired t test: p < 0.001), respectively. These were significantly correlated (Pearson r = 0.932, p < 0.001, ICC 0.850 (0.825–0.872), bias 0.99 ± 4.33 kPa [95% limits of agreement − 9.48 to + 7.49] with proportional error towards higher LSM values). LSM-2D-SWE values significantly increased with TE categories (ANOVA: p < 0.001). AUROCs ranged from 0.935 ± 0.010 (95% CI 0.910–0.954) to 0.973 ± 0.009 (95% CI 0.955–0.985), resulting in correct classification of 390/537 (73%) patients. Three 2D-SWE measurements were sufficient for reliable LSMs.

Conclusion

LSM using 2D-SWE correlates well with TE. It tends to underestimate higher stages of liver fibrosis but correctly classifies the majority of patients. It may be used in TE-derived algorithms to manage patients.

Key Points

• Liver stiffness measurement (LSM) by 2D-shear wave elastography (2D-SWE) and transient elastography (TE) are strongly correlated.

• 2D-SWE shows proportionately lower LSM values compared to TE, particularly with the higher LSM range.

• Three individual measurements by 2D-SWE are sufficient to assess LSM reliably.

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Abbreviations

CI:

Confidence interval

HBV:

Hepatitis B virus

HCV:

Hepatitis C virus

ICC:

Intraclass correlation coefficient

kPa:

Kilopascal

LOA:

Limit of agreement

LSM:

Liver stiffness measurement

NAFLD:

Non-alcoholic fatty liver disease

ROC:

Receiver operating characteristic

SWE:

Shear wave elastography

TE:

Transient elastography

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Funding

This study has received funding by Canon Medical Systems, Japan.

Author information

Authors and Affiliations

  1. Department of Radiology, Beaujon University Hospital, APHP.Nord, Clichy, France

    Maxime Ronot & Valérie Vilgrain

  2. Université de Paris, Paris, France

    Maxime Ronot & Valérie Vilgrain

  3. Department of Clinical Sciences and Infectious Diseases, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy

    Giovanna Ferraioli & Carlo Filice

  4. Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy

    Giovanna Ferraioli & Carlo Filice

  5. Department of Hepatology and Imaging, Charité Hospital, University of Berlin, Berlin, Germany

    Hans-Peter Müller

  6. Department of Internal Medicine 1, Division of Gastroenterology and Hepatology, Goethe University Hospital, Frankfurt, Germany

    Mireen Friedrich-Rust

  7. Department of Imaging, Imperial College Healthcare NHS Trust, Charing Cross Hospital, Fulham Palace Road, London, W6 8RF, UK

    David Cosgrove & Adrian K. Lim

Authors
  1. Maxime Ronot
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  2. Giovanna Ferraioli
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  3. Hans-Peter Müller
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  4. Mireen Friedrich-Rust
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  5. Carlo Filice
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  6. Valérie Vilgrain
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  8. Adrian K. Lim
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Corresponding author

Correspondence to Maxime Ronot.

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Guarantor

The scientific guarantor of this publication is Maxime Ronot.

Conflict of interest

The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.

Statistics and biometry

No complex statistical methods were necessary for this paper.

Informed consent

Written informed consent was obtained from all subjects (patients) in this study.

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Institutional review board approval was obtained.

Methodology

• prospective

• diagnostic or prognostic study

• multi-centre study

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David Cosgrove had already passed away.

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Ronot, M., Ferraioli, G., Müller, HP. et al. Comparison of liver stiffness measurements by a 2D-shear wave technique and transient elastography: results from a European prospective multi-centre study. Eur Radiol 31, 1578–1587 (2021). https://doi.org/10.1007/s00330-020-07212-x

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  • DOI: https://doi.org/10.1007/s00330-020-07212-x

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